title: Morbidity of left pancreatectomy when associated with multivisceral resection for abdominal mesenchymal neoplasms.
abstract: BACKGROUND
  Resection of adjacent visceral organs is often required in surgery for abdominal mesenchymal tumors.
  
  
  OBJECTIVE
  To analyze the specific perioperative morbidity and mortality of a left pancreatectomy in multivisceral resections for mesenchymal tumors.
  
  
  METHODS
  This paper considered all patients treated at National Cancer Institute, Milan, Italy, from January 1997 to May 2009 for the resection of abdominal mesenchymal neoplasms requiring a concomitant left pancreatectomy. The extension of surgery, pathology of both the tumor and the pancreatic tissue, completeness of resection, administration of pre or postoperative treatments and postoperative outcome were analyzed. The overall survival of the entire population was also assessed.
  
  
  RESULTS
  Fifty-seven patients affected by localized left retroperitoneal mesenchymal neoplasms or intra-abdominal gastrointestinal stromal tumors were identified. A macroscopically complete resection was achieved in all but 3 patients (5.3%) and the neoplastic involvement of pancreatic tissue was documented at pathology in 26 (45.6%) patients. Surgical postoperative complications occurred in 20 patients (35.1%); 7 patients (12.3%) developed a postoperative pancreatic fistula. With a median follow-up of the surviving patients of 32 months (interquartile range: 20-57 months), the overall survival at 5 years was 67.0%.
  
  
  CONCLUSIONS
  Left pancreatic resection seemed to be a safe procedure, even when it is part of a multivisceral resection for abdominal mesenchymal neoplasms. When margins are crucial for cure, the left pancreas should then always be resected, independently of its direct infiltration.
authors.affiliation: Department of Surgery, National Cancer Institute. Milan, Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Berselli
authors.forename: Sara
authors.initials: S
authors.lastname: Coppola
authors.forename: Chiara
authors.initials: C
authors.lastname: Colombo
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Pennacchioli
authors.forename: Marco
authors.initials: M
authors.lastname: Fiore
authors.forename: Alessandro
authors.initials: A
authors.lastname: Gronchi
mesh_terms: D000008:Abdominal Neoplasms / Q000453:epidemiology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D046152:Gastrointestinal Stromal Tumors / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007558:Italy / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D017063:Outcome Assessment, Health Care; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D010185:Pancreatic Fistula / Q000175:diagnosis / Q000209:etiology; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D013154:Spleen / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D014781:Viscera / Q000473:pathology / Q000601:surgery*